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Open Access Research article

Patterns in mortality among people with severe mental disorders across birth cohorts: a register-based study of Denmark and Finland in 1982–2006

Mika Gissler12*, Thomas Munk Laursen13, Urban Ösby45, Merete Nordentoft6 and Kristian Wahlbeck12

Author Affiliations

1 Nordic Research Academy in Mental Health, Nordic School of Public Health, Gothenburg, Sweden

2 THL National Institute for Health and Welfare, Helsinki, Finland

3 National Centre for Register-based Research, Aarhus University, Aarhus, Denmark

4 Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden

5 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

6 Psychiatric Centre Bispebjerg, Copenhagen University, Faculty of Health Sciences, Copenhagen, Denmark

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BMC Public Health 2013, 13:834  doi:10.1186/1471-2458-13-834

Published: 11 September 2013

Abstract

Background

Mortality among patients with mental disorders is higher than in general population. By using national longitudinal registers, we studied mortality changes and excess mortality across birth cohorts among people with severe mental disorders in Denmark and Finland.

Methods

A cohort of all patients admitted with a psychiatric disorder in 1982–2006 was followed until death or 31 December 2006. Total mortality rates were calculated for five-year birth cohorts from 1918–1922 until 1983–1987 for people with mental disorder and compared to the mortality rates among the general population.

Results

Mortality among patients with severe mental disorders declined, but patients with mental disorders had a higher mortality than general population in all birth cohorts in both countries. We observed two exceptions to the declining mortality differences. First, the excess mortality stagnated among Finnish men born in 1963–1987, and remained five to six times higher than at ages 15–24 years in general. Second, the excess mortality stagnated for Danish and Finnish women born in 1933–1957, and remained six-fold in Denmark and Finland at ages 45–49 years and seven-fold in Denmark at ages 40–44 years compared to general population.

Conclusions

The mortality gap between people with severe mental disorders and the general population decreased, but there was no improvement for young Finnish men with mental disorders. The Finnish recession in the early 1990s may have adversely affected mortality of adolescent and young adult men with mental disorders. Among women born 1933–1957, the lack of improvement may reflect adverse effects of the era of extensive hospitalisation of people with mental disorders in both countries.

Keywords:
Birth cohort; Mental disorder; Mortality; Psychiatric care; Register study